2018 YEAR END AWARD SIGN-UP

Transcription

1 HORSE SHOW DIVISION P.O. Box 1010 McKenna, WA YEAR END AWARD SIGN-UP This participation form must be sent to the above address or turned in to a WSH Show Steward prior to the first WSH approved Horse Show. Incomplete applications cannot be processed until all REQUIRED information is received. 1. NAME OF HORSE: BREED: REGISTRATION #: SECONDARY / 2 ND BREED: SECONDARY BREED REGISTRATION #: HORSE BLANKET SIZE: COPY OF REGISTRATION PAPERS SENT: Y N/A 2. RIDER / OWNER / LESSEE SECTION NAME: RIDER/OWNER/LESSEE (SELECT ONE): ADDRESS: City: STATE: ZIP CODE: PHONE: PERMANENT WSH BACK #: WSH #: --OR-- NUMBER REQUESTED NEW WSH EXHIBITOR? Y N 3. AGE & DIVISION SECTION: *Check the appropriate box below: Leadline Walk-Trot 10 & Under & Over AMATEUR # FOR 18 & OVER EXHIBITOR PARTICIPATING IN EQUITATION OR AMATEUR CLASS: USEF #: WSH AM. CARD NEEDED: Y N (See Pg 3 of this packet) Other Breed Am. Card: *WSH Amateur Fee waived with 2 High Score Award Classes JACKET SIZE (Circle): S M L XL XXL MENS: LADIES CHILD *REMINDER: THIS PAGE 1 OF2, (3-4 Optional) MUST BE MAILED TO ADDRESS ABOVE OR HANDED TO HORSE SHOW STEWARD* 4. CLASS REGISTRATION SECTION: 1

2 *Classes to sign-up for the current show season (classes are listed beginning on page 6): Ex. AP01 WSH RULE BOOK: Y N Fees: B System Classes: $12 each $ Flat fee for UNLIMITED B System classes: $200 $ A System classes: $17 each $ WSH Amateur Card (*Waived if signing up for 2 classes) $ $12 WSH Member $15 Non-Member Rulebook + P/H: $10 $ ROM Enrollment Fee: $20 (See page 4) $ TOTAL FEES (*Check/Money Order to WSH) $ THIS RELEASE MUST BE SIGNED IMPORTANT PLEASE READ I AGREE in consideration for my participation in any WSH Competition to the following: I AGREE that I choose to participate voluntarily in the Competition with my horse, as a rider, driver, handler, lessee, owner, agent, coach trainer, or as parent or guardian of a junior exhibitor. I am fully aware and acknowledge that horse sports and the Competition involve inherent dangerous risks of accident, loss, and serious bodily injury including broken bones, head injuries, trauma, pain, suffering, or death ( Harm ). I AGREE to release Washington State Horsemen and any WSH horse shows from all claims for money damages or otherwise for any Harm to me or my horse and for any Harm caused by me or my horse to others, even if the Harm resulted, directly or indirectly, from the negligence of Washington State Horsemen or the Competition. I AGREE to expressly assume all risks of Harm to me or my horse, including Harm resulting from the negligence of Washington State Horsemen or the competition. I AGREE to indemnify (that is, to pay any losses, damages, or costs incurred by) Washington State Horsemen and the Competition and to hold them harmless with respect to claims for Harm to me or my horse and for claims made by others for any Harm caused by me or my Horse at the competition. I have read the Washington State Horsemen Rules about protective equipment, and I understand that I am entitled to wear protective equipment without penalty, and I acknowledge that Washington State Horsemen strongly encourages me to do so while WARNING that protective equipment cannot guard against all injuries. If I am a parent or guardian of a junior exhibitor, I consent to the child s participate and AGREE to all of the above provisions and AGREEE to assume all of the obligations of this Release on the child s behalf. I AGREE that Washington State Horsemen and Competition as used above includes all of their officials, officers, directors, employees, agents, personnel, volunteers and affiliated organizations. The construction or application of Washington State Horsemen rules are governed by the laws of the State of Washington. (RCW 4.4) Signatures (mandatory) Rider/Driver/Handler Dated Print Name Parent/Guardian Signature Print Name *REMINDER: THIS PAGE 2 OF 2, (3-4 optional) MUST BE MAILED TO ADDRESS ABOVE OR HANDED TO HORSE SHOW STEWARD* APPLICATION FOR AMATEUR CERTIFICATION: 2

3 $12 Fee or free if participating in 2 WSH Year End Award Classes or 1 Dressage Division MAIL TO: WSH HSD, PO Box 1010, McKenna, Wa Sr. Exhibitors 18 & over planning to compete in Equitation Division, Jack Benny Pleasure, and Adult Am. Hunter must complete this form & pay applicable fees. I hereby apply for WSH Amateur Certification and enclose payment of $ NAME (Please Print) PHONE # ( ) ADDRESS: CITY STATE ZIP Regardless of one s equestrian skills and/or accomplishments, a person is an amateur for all competitions conducted under WSH rules who after his/her 18 th birthday has not engaged in any of the following activities which would make him/her a professional. a. Accepts remuneration for riding, driving, showing in halter/in hand, training schooling or conducting clinics or seminars. b. Accepts remuneration for giving instruction in equitation or horse training. Persons acting as counselors at summer camps or giving training to the handicapped are excluded. c. Rides, drives or shows in halter/in hand competitions, any horse for which he/she or a member of his/her family or a corporation which a member of his/her family controls, receives remuneration for boarding, training, riding, driving or showing. d. Gives instruction to any person or rides, drives or shows in competitions any horse, for which activity another person in his/her family or corporation which a member of his/her family controls will receive remuneration for the activity. Receiving monies from classes that offer scholarship bonds or premium monies from local fairs is exempt from both Jr. and Sr. Amateur. See the USEF Rulebook for a complete listing of activities that do not affect the amateur status of a person The following activities do not affect the amateur status of a person who is otherwise qualified: a. The writing of books or articles pertaining to horses. b. Accepting remuneration for officiating as a judge, steward, technical delegate, course designer, announcer or participating as a TV commentator, or accepting bona fide remuneration for services as a veterinarian, groom, farrier, tack shop operator or breeder, or for accepting bona fide remuneration for boarding services. c. Accepting reimbursement for expenses without profit. d. Accepting a token of appreciation, other than money, for riding, driving or showing in halter/in hand. (Note: Horse board, prize money, partial support or objects of more than $300 are considered remuneration, not small tokens of appreciation). (Also note; accepting any amount of money, whether more or less than $300 is considered remuneration.) Prize money won by an amateur-owner rider/driver/handler in any class (other than equitation or showmanship) is not considered remuneration. e. Having the occupation of veterinarian, groom, farrier or owning a tack shop or breeding or boarding stable in itself, does not affect the amateur status of a person who is otherwise qualified. f. Any person who is serving an internship for college credit through his/her respective, accredited college program, and who has never held professional status can accept reimbursement for expenses without profit. Signed Dated *REMINDER: THIS PAGE 3 OF 4 IF APPLICABLE NEEDS TO BE MAILED TO ADDRESS ABOVE OR HANDED TO HORSE SHOW STEWARD* 2018 REGISTER OF MERIT (ROM) PROGRAM: 3

4 ROM QUESTIONS: TERI BLAIR Teri Blair: Mail ROM Forms to - Teri Blair, Merit Chair th Avenue Court E-Graham, WA (Requirements and Participation rules are in the current WSH HSD Rulebook or contact the Horse Show Director/Show Steward at a WSH Show) Please fill form out completely. Incomplete forms will be returned. Dressage sign-up on back page. NAME: ZONE: WSH BACK #: ADDRESS: CITY/STATE: ZIP CODE: PHONE: ADDRESS: HORSES REGISTERED NAME: BLACK JACKET: _women s or men s_size: VEST women s or men s size: SHEET - size: **YOU ARE RESPONSIBLE FOR KEEPING TRACK OF YOUR OWN POINTS. POINT TOTALS MUST BE INCLUDED WHEN POINTS ARE FULFILLED. YOU MAY REQUEST A POINT TOTAL FROM THE HORSE SHOW DIRECTOR FOR $10.00 IN THE CURRENT YEAR. JACKET, VEST & /SHEET MUST BE ORDERED BY OCTOBER 5, BUCKLES MUST BE ORDERED BY SEPTEMBER 1, EXTRA $25.00 FEE FOR THOSE ORDERING AFTER OCT. 5, ROM (sheet, jacket or vest) Enrollment Renewal Fee Award Fee Points Required Points Carried Forward ( ) Halter Horse $20.00 $ ( ) English Horse $20.00 $ ( ) Western Horse $20.00 $ ( ) Driving Horse $20.00 $ ( ) Hunter-Jumper $20.00 $ ( ) Equitation Jr/Sr $20.00 $ ( ) Trail (Ridden/In Hand) $20.00 $ SUPERIOR (Buckle) ( ) Halter $20.00 $ ( ) Equitation $20.00 $ ( ) Performance $20.00 $ specialty ( ) Driving $20.00 $ specialty ( ) Trail (ridden/in Hand) $20.00 $ SUPREME (Buckle) ( ) Show Horse $20.00 $ West, 500 Eng. 500 specialty classes ( ) Halter Horse $20.00 $ ( ) Driving $20.00 $ ; 50 in champ. and 50 in specialty class ( ) Advanced Equitation $20.00 $ and 300 in advanced or medal classes ( ) Trail (Ridden or In Hand) $20.00 $ ULTRA SUPREME (Buckle) ( ) $20.00 no fee completion of all levels DRESSAGE ROM : 4

5 ROM (sheet, jacket or vest Enrollment renewal fee Award Fee Scores required Number of Tests ( ) Dressage Intro Level $20.00 $ scores of 60% or higher ( ) Dressage Training Level $20.00 $ scores of 60% or higher ( ) Dressage First Level $20.00 $ scores of 60% or higher ( ) Dressage Second Level $20.00 $ scores of 60% or higher ( ) Dressage Third Level $20.00 $ scores of 60% or higher ( ) Dressage Fourth Level $20.00 $ scores of 60% or higher ( ) Western Dressage Intro Level $20.00 $ scores of 60% or higher ( ) Western Dressage Training Level $20.00 $ scores of 60% or higher ( ) Western Dressage First Level $20.00 $ scores of 60% or higher ( ) Western Dressage Second Level $20.00 $ scores of 60% or higher ( ) Western Dressage Third Level $20.00 $ scores of 60% or higher ( ) Western Dressage Fourth Level $20.00 $ scores of 60% or higher SUPERIOR (Cooler) ( ) Dressage Intro Level $20.00 $ scores of 60% or higher ( ) Dressage Training Level $20.00 $ scores of 60% or higher ( ) Dressage First Level $20.00 $ scores of 60% or higher ( ) Dressage Second Level $20.00 $ scores of 60% or higher ( ) Dressage Third Level $20.00 $ scores of 60% or higher ( ) Dressage Fourth Level $20.00 $ scores of 60% or higher ( ) Western Dressage Intro Level $20.00 $ scores of 60% or higher ( ) Western Dressage Training Level $20.00 $ scores of 60% or higher ( ) Western Dressage First Level $20.00 $ scores of 60% or higher ( ) Western Dressage Second Level $20.00 $ scores of 60% or higher ( ) Western Dressage Third Level $20.00 $ scores of 60% or higher ( ) Western Dressage Fourth Level $20.00 $ scores of 60% or higher SUPREME (Cooler) ( ) Dressage Intro Level $20.00 $ scores of 60% or higher ( ) Dressage Training Level $20.00 $ scores of 60% or higher ( ) Dressage First Level $20.00 $ scores of 60% or higher ( ) Dressage Second Level $20.00 $ scores of 60% or higher ( ) Dressage Third Level $20.00 $ scores of 60% or higher ( ) Dressage Fourth Level $20.00 $ scores of 60% or higher ( ) Western Dressage Intro Level $20.00 $ scores of 60% or higher ( ) Western Dressage Training Level $20.00 $ scores of 60% or higher ( ) Western Dressage First Level $20.00 $ scores of 60% or higher ( ) Western Dressage Second Level $20.00 $ scores of 60% or higher ( ) Western Dressage Third Level $20.00 $ scores of 60% or higher ( ) Western Dressage Fourth Level $20.00 $ scores of 60% or higher *REMINDER: THIS PAGE 4 OF 4 IF PARTICIPATING NEEDS TO BE MAILED TO ADDRESS ABOVE OR HANDED TO HORSE SHOW STEWARD* 5

6 INSTRUCTIONS ON SIGNING UP FOR WSH HSD STATE YEAR END AWARDS The following pages should be retained by you Participation forms with proper fees must be postmarked before the first Horse Show in which you intend to compete for points. You may hand it to the Show Steward at the Show as well. WSH Membership is Mandatory for Points to Count. Be sure to return the Page 1 & 2 (front and back) and page 3 if you are applying for a WSH Amateur Card, with the total fees (checks made out to WSH ) to WSH, P.O. Box 1010, McKenna, WA Submit Page 4 if participating in ROM (Register of Merit) to the Graham address at the bottom of that form. Submit Page 10 which is the WSH Membership (Non-Club) form, to: WSH, P.O. Box 1010, McKenna, WA If you have acquired your membership through a Club, please indicate your membership number on the front page. WSH has two categories of Shows; the A System (Breed Shows) and B System which are WSH approved Open Horse Shows. A System/Breed Show Exhibitors must report points to the Horse Show Director. This form can be downloaded on WSH approved B System Horse Shows will send in the results to the HS Pointskeeper. However, we encourage you to keep a record of your points for audit purposes. WSH Permanent Number will be assigned to you by the HS Director or the HS Steward if you are a new exhibitor to WSH. This number must be used at any WSH approved horse show if you are signed up for State Year End Awards. WSH accepts USEF Amateur Number, Major Breed Amateur Number (see complete list in current WSH Rulebook) or you can apply for a WSH Amateur number. If you are 18 & over, and plan to ride in any Equitation classes or in any other Amateur classes (such as, Jack Benny E/W Pleasure), you will need to complete the application for Amateur Certification on page 3 of this packet. If you sign up for at least two State Year End Awards, the fee will be waived. Otherwise, the Amateur card is $12.00 for WSH member and $15.00 if a Non WSH Member. The competition Release Form (Hold Harmless Agreement) must be signed in order to complete your WSH Horse Show Year End Award Sign up on page 2, The WSH Horse Show Division Rulebook can be found on the WSH website. A printed rulebook may be purchased and mailed to you; indicate this choice on page 2. Please select the classes you would like to sign up for from the list below and enter the applicable 4, 5 or 6 digit code in the table at the top of Page 2. The A System only classes will be $17.00 per marked class, B System only classes will be $12.00 for each class (or a blanket fee of $ for unlimited classes). If you sign up for a Combined A and B System class (if you will only be attending B system shows, you will still only pay $12.00) each will cost the $17.00 and you will receive points in both A System shows (which you must send in your results) and B System classes (do not send in points). A SYSTEM (All Breeds except Miniature Horse ) ASYS01 Halter ASYS02 English Pleasure ASYS03 Western Pleasure ASYS04 Driving ASYS05 Amateur/Non-Pro ASYS06 Youth ASYS07 Working ( Ranch Riding, Versatile Ranch Horse, Trail, Reining, Western Riding 10 AND UNDER LEADLINE,WALK AND WHOA, WALK TROT 10 AND UNDER TEN 1 Leadline Equitation E/W, Riders 6 & Under TEN 2 Walk-Trot Pleasure E/W, Riders 10 & Under TEN 3 Walk-Trot Equitation E/W, Riders 10 & Under TEN 4 Mary Ann Bonwell Walk/Trot Trail, Riders 10 & Under TEN 5 Walk Whoa Equitation, English or Western, Riders 8 Yrs. & Under EQ01 Showmanship, English/Western Jr. Ex. 10 & under (Also Listed in Equitation) ALL OTHER BREED B SYSTEM ONLY AOB01 Halter AOB02 English Pleasure AOB03 Western Pleasure 6

7 APPALOOSA HORSE B SYSTEM ONLY AP01 Halter AP02 English Pleasure AP03 Western Pleasure ARABIAN HORSE B SYSTEM ONLY AR01 Halter AR02 English Pleasure AR03 Western Pleasure HALF ARABIAN HORSE B SYSTEM ONLY AR04 Halter AR05 English Pleasure AR06 Western Pleasure BUCKSKIN HORSE B SYSTEM ONLY BK01 Halter BK02 Hunter Under Saddle BK03 Western Pleasure DRIVING HORSE/MINIATURE/PONY B SYSTEM ONLY DR01 Pleasure Driving, Green H/P, 1 st /2 nd Yr. DR02 Obstacle Driving DR03 Pleasure Driving H/P Open DR04 Reinsmanship DR05 Precision Driving ENGLISH B SYSTEM ONLY EN01 Advanced English Pleasure EN02 English Pleasure, Colored Horses EN03 English Pleasure, Non-Colored Horses EN04 English Pleasure Horse, Jr. Exhibitor 13 & Under EN05 English Pleasure Horse, Jr. Exhibitor EN06 English Pleasure Horse, Sr. Exhibitor 18 & Over EN07 English Pleasure, Open EN08 English Pleasure Other Than Hunter Type, All Ages EN09 English Pleasure, Green Horse 1 st & 2 nd Yr. W/T EN10 English Pleasure, Green Horse 1 st & 2 nd Yr. EN11 English Pleasure, Green Rider 1 st & 2 nd Yr. W/T EN12 English Pleasure, Green Rider 1 st & 2 nd Yr. EN13 Jack Benny Pleasure E/W Sr. Am 39 Yrs & over (must have an Amateur Card) (this class is also listed under the Western Division only sign up for one or the other) EN14 English Pleasure, Limit Horse W/T EN15 English Pleasure, Limit Horse EN16 English Pleasure, Limit Rider W/T EN17 English Pleasure, Limit Rider EN18 Road Hack EN19 Show Hack EN20 English Pleasure, Amateur, WT EN21 English Pleasure, Open, WT EQUITATION B SYSTEM ONLY-Sr. Ex. 18 & Over exhibitors must have ApHC, ABRA, AQHA, AMHA, APHA, PtHA, NRHA, WSH, USEF Amateur Cards/Non-Pro Card or Youth Novice Cards. 7

8 EQ01 Showmanship, English/Western Jr. Ex. 10 & under ( Also offered in 10 and Under) EQ02 Showmanship, English/Western Jr. Ex EQ03 Showmanship, English/Western Jr. Ex EQ04 Showmanship, English /Western Sr. Am. 18 & Over EQ05 Showmanship, E/W, Limit Handler EQ06 Showmanship, E/W, Green Handler 1 st /2 nd Yr. Jr./Sr. Am. EQ07 Hunter Seat Equitation (NTJ-Not to Jump), Jr. Ex. 13 & Under EQ08 Hunter Seat Equitation (NTJ), Jr. Ex EQ09 Hunter Seat Equitation (NTJ), Sr. Am. 18 & Over EQ10 Saddle Seat/Saddle Seat Pleasure Equitation Jr. /Sr. Am. EQ11 HS/SS Equitation Jr./Sr. Am. Pattern Only EQ12 English Equitation, Limit Rider, Jr./Sr. Am. W/T EQ13 English Equitation, Limit Rider Jr./Sr. Am. EQ14 English Equitation, Green Rider Jr./Sr. Am. W/T EQ15 English Equitation, Green Rider Jr./Sr. Am. EQ16 Western Seat Equitation, Jr. Ex. 13 & under EQ17 Western Seat Equitation, Jr. Ex EQ18 Western Seat Equitation, Sr. Am. 18 & Over EQ19 Western Seat Horsemanship, Jr. Ex. 17 & Under/Sr. Am. 18 & Over Pattern Only EQ20 Western Equitation, Limit Rider Jr./Sr. Am. W/J EQ21 Western Equitation, Limit Rider Jr./Sr. Am. EQ22 Bareback Horsemanship, E/W, Jr./Sr. Am. EQ23 Western Equitation, Green Rider 1 st /2 nd Yr. Jr./Sr. Am. W/J EQ24 Western Equitation, Green Rider 1 st & 2 nd Yr. Jr./Sr. Am HUNTER DIVISION-ON THE FLAT- B SYSTEM ONLY HD01 English Pleasure Hunter Type, Jr. Ex. 13 & under HD02 English Pleasure Hunter Type, Jr. Ex HD03 English Pleasure Hunter Type, Sr. Ex. 18 & over HUNTER /JUMPER DIVISION-OVER FENCE CLASSES- A AND B SYSTEM COMBINED HJ01 Hunter Hack HJ02 Adult Amateur Hunter (Must have USEF/WSH Amateur Card) HJ03 Junior Hunter Ex. 17 & Under HJ04 Low Working Hunter HJ05 Pre-Green Hunter Over Fences HJ06 Regular Working Hunter HJ07 Beginner Hunter 18 HJ08 Jr./Amateur Jumper (Must have an Amateur Card) 2 9 HJ09 Limit Jumper 2 6 HJ10 Open Jumper 2 9 MINIATURE HORSE- A AND B SYSTEM COMBINED MI01 Miniature Horse Halter MI02 Miniature Horse Obstacle In Hand MI03 Miniature Horse Pleasure Driving MI04 Miniature Horse Ideal Driving MI05 Miniature Horse Discipline Rail MISCELLANEOUS CLASSES B SYSTEM ONLY LL01 Longe Line 3 years & under (Not to cross enter riding classes at same show) MORGAN HORSE- B SYSTEM ONLY 8

9 MO01 Morgan Horse In Hand MO02 Morgan English Pleasure MO03 Morgan Western Pleasure PAINT HORSE- B SYSTEM ONLY PA01 Paint Horse Halter PA02 Paint Horse Hunter Under Saddle (BPH) PA03 Paint Western Pleasure Horse PINTO HORSE- B SYSTEM ONLY PT01 Pinto Halter PT02 Pinto Performance Horse, English PT03 Pinto Performance Horse, Western PONY- B SYSTEM ONLY PO01 Pony Pleasure In Hand PO02 Pony Pleasure Driving 14.2 h & under, Open PO03 Pony Pleasure Driving 14.2 h & under, Green 1 st & 2 nd Yr. PO04 Ideal Pony Driving Class PO05 Roadster Pony, 12.2 Hands & Under QUARTER HORSE- B SYSTEM ONLY QH01 Quarter Horse Halter QH02 Quarter Horse Hunter Under Saddle QH03 Quarter Horse Western Pleasure REINING- A AND B SYSTEM COMBINED RH01 Reining, Amateur RH02 Reining, Open RH03 Reining, Green Horse, 1 st & 2 nd Yr. RH04 Reining, Green Rider, 1 st & 2 nd Yr. WESTERN DIVISION*PLEASURE - B SYSTEM ONLY WD01 Advanced Western Pleasure WD02 Western Pleasure, Colored Horses WD03 Western Pleasure, Non-Colored Horses WD04 Pleasure Horse, Green Western 1 st & 2 nd Yr. W/J WD05 Pleasure Horse, Green Western 1 st & 2 nd Yr. WD06 Western Pleasure, Green Rider 1 st & 2 nd Yr. W/J WD07 Western Pleasure, Green Rider 1 st & 2 nd Yr. WD08 Jack Benny Pleasure E/W Sr. Am 39 Yrs & over (must have an Amateur Card) (this class is also listed under the English Division only sign up for one or the other) WD09 Jim Webb Memorial Western Pleasure Sr. Ex. 31 & Over WD10 Western Pleasure Limit Horse W/J WD11 Western Pleasure Limit Horse WD12 Western Pleasure, Limit Rider W/J WD13 Western Pleasure, Limit Rider WD14 Western Pleasure Jr. Ex. 13 & Under Continued on next page WD15 Western Pleasure Jr. Ex WD16 Western Pleasure Sr. Ex WD17 Western Pleasure Sr. Ex. 50 & Over WD18 Western Pleasure Open 9

10 WD19 Western Pleasure, Amateur, WJ WD20 Western Pleasure, Open, WJ WESTERN DIVISION*TRAIL B SYSTEM ONLY TR01 Adolescent Trail Horse In Hand, 3 Yrs. & Under TR02 Trail In Hand, Open TR03 Trail Horse, E/W, Jr. Ex. 13 & Under TR04 Trail Horse, E/W, Jr. Ex TR05 Trail Horse, E/W, Sr. Ex. 18 & Over TR06 Trail Horse, E/W, Green 1 st & 2 nd Yr. TR07 Trail Horse, E/W, Amateur, WT TR08 Trail Horse, E/W, Open, WT WESTERN DIVISION*WORKING B SYSTEM ONLY WD21 Western Riding, Open WD22 Ranch Riding, Open See WSH current Rulebook for further class specifications and Perpetual Awards for each Division which is calculated on total points for the year with the exception of Green and Limit Classes. The following Divisions are currently Inactive: Fox Trotter Gaited Mustang National Show Horse Palomino POA Saddlebred Special Needs/Disabled Welsh. Contact the Horse Show Director if there is Exhibitor and/or Horse Show interest in future reactivation. *KEEP THESE PAGES FOR YOUR REFERENCE* YOU MUST BE A WSH MEMBER TO COMPETE FOR YEAR END AWARDS. EITHER JOIN THROUGH A WSH CLUB OR COMPLETE THE FORM ON NEXT PAGE Revised 1/5/18 10

11 2017 WSH MEMBER APPLICATION / RENEWAL: NON-CLUB AFFILIATION To qualify for many of the Year-End Award programs offered through WSH, you must be a current member of WSH. You must show a copy of your current WSH Card at approved events. Membership is open to anyone who is interested in joining. WSH consists of riders who participate in Competitive Trail, Horse Show, Trails and Pleasure, Western Games and Working Horse Events. This membership is for the period of January 1 through December 31. Complete this form if you are not affiliated with a Club within WSH. If you are affiliated with a Club, you may join through the club. Juniors are those 17 years of age or under. Amateurs are those 18 and over who meet the Amateur guidelines. LAST NAME FIRST NAME MEMBER TYPE* BIRTHDATE ** NEW OR RENEWAL *Member Type: Jr / Sr / Amateur / Open **Birthdate - Jr ADDRESS: PHONE: ALTERNATE PHONE: AREAS OF INTEREST: (Circle) Horse Shows Trails and Pleasure Western Games Working Horse Youth Membership (Under 18) $15 $ Non Youth Individual Membership $27 $ Family Membership $43 $ How did you find out about WSH? Please make check or Money order to WSH and mail to: WSH Membership Chair Teri Blair- Terblair62@gmail.com th Avenue Court E-Graham, WA For questions or other inquiries, send them to info@washingtonstatehorsemen.org 11